Organization
THOMAS M. ERICHSON, O.D., P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS M. ERICHSON O.D. (OWNER)
(845) 471-1147
Entity
Organization
Contact information
Practice address
1 BUSHWICK RD STE B, POUGHKEEPSIE, NY 12603-3839
(845) 471-1147
(845) 473-1849
Mailing address
1 BUSHWICK RD STE B, POUGHKEEPSIE, NY 12603-3839
(845) 471-1147
(845) 473-1849
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV004036
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A100046955
GROUP PTAN
NY
01
—
A400047000
GROUP MEMBER PTAN
NY
Enumeration date
10/07/2010
Last updated
10/31/2013
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